不同主动脉球囊反搏治疗时机在高危急性心肌梗死PCI术中的应用

目的:评价预防性置入主动脉球囊反搏(IABP)和被动紧急置入主动脉球囊反搏在高危急性心肌梗死(AMI)PCI患者中应用的效果。方法:A组25例为入院时行急诊PCI术治疗前预防性置入IABP;而B组23例为术中或术后血流动力学不稳定、心功能不全、低心排综合征等接受IABP紧急置入。分析A、B两组术后临床效果,比较两组术后病死率、并发症发生率、术后心血管活性药物应用、IABP使用时间。结果:A组术后病死率和并发症发生率为8.0%和0%,B组为47.8%和0%;术后平均正性肌力药物辅助时间分别为(52.6±15.7)h与(89.8±12.7)h,P0.05;平均IABP使用时间分别为(44.6±17.4)h与(87.1±22.2)h,P0.05。结论:对于高危冠状动脉PCI患者,术前预防性置入IABP能减少正性肌力药物辅助时间,缩短IABP辅助时间,降低术后病死率。

Application of Counterpulsation Opportunity with Different Intra-aortic Balloon in PCI in Patients with Severe Acute Myocardial Infarction

Objective： To evaluate the effect of preventive placing the intra-aortic balloon counterputsation （IABP） and passive emergency placing IABP in PCI in patients with severe acute myocardial infarction. Method：The patients（n=25） in A group received the preventive placing IABP before the emergency PCI,and the patients（n=23） in B group received the passive emergency placing IABP in or a{ter PCI when they showed the hemodynamics unstable,the cardiac insufficiency,the low cardiac output syndrome,etc. The clinical effects of two groups were analysed, and the fatality rate,the complication rate,the postoperative cardioactive drug using and the using time of IABP were compared between A and t3 after operation. Results：The fatality rate and the complication rate were 8.0% and 0% respectively in A group, and 47.8% and 0% respectively in B group. The average using time of positive inotropic drugs was （52.6±15.7） h and （89.8±12.7） h respectively in group A and B（P〈0.05）. The average using time of IABP was （44.6 ±17.4） h and （87.1±22.2） h respectively in group A and B（P〈0.05）. Conclusion.. The preventive placing IABP can decrease the using time of positive inotropic drugs and the using time of IABP,while reduce the fatality rate.